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To determine which of 8 commonly employed frailty assessment tools demonstrate the most appropriate characteristics to be employed in different clinical and social settings.

Cross-sectional multicenter European-based study.

1440 patients aged ≥75years evaluated in geriatric inpatient wards, geriatric outpatient clinics, primary care clinics, and nursing homes.

The frailty instruments used were Frailty Phenotype, SHARE-FI, 3-item Frailty Trait Scale (FTS-3), 5-item Frailty Trait Scale (FTS-5), FRAIL, 35-item Frailty Index (FI-35), Gérontopôle Frailty Screening Tool (GFST), and Clinical Frailty Scale (CFS). The settings were geriatrics wards, outpatient clinics, primary care, and nursing homes. Suitability was evaluated by considering the feasibility (patients with the test fully completed), administration time (time spent for administering the test), and interscale agreement (Cohen kappa index among instruments to detect frailty).

The prevalence of frailty varied across settings and adopted tests. find more The scales with the mean highest feasibility were the FRAIL scale (99.4%), SHARE-FI (98.3%), and GFST (95.0%). The mean shortest administration times were obtained with CFS (24seconds), GFST (72seconds), and FRAIL scale (90seconds). The interscale agreement between most of the tests was fair. CFS followed by FTS-5 agreed at least moderately with a greater number of scales overall and in almost all settings.

Based on feasibility, time to undertake the tool, and agreement with other scales, different scales would be recommended according to the setting considered. Our findings suggest that most of the tools evaluated are actually assessing different frailty constructs.
Based on feasibility, time to undertake the tool, and agreement with other scales, different scales would be recommended according to the setting considered. Our findings suggest that most of the tools evaluated are actually assessing different frailty constructs.Accurate and timely transmission of medical records between skilled nursing facilities and acute care settings has been logistically problematic. Often people are sent to the hospital with a packet of paper records, which is easily misplaced. The COVID-19 pandemic has further magnified this problem by the possibility of viral transmission via fomites. To protect themselves, staff and providers were donning personal protective equipment to review paper records, which was time-consuming and wasteful. We describe an innovative process developed by a team of hospital leadership, members of a local collaborative of skilled nursing facilities, and leadership of this collaborative group, to address this problem. Many possible solutions were suggested and reviewed. We describe the reasons for selecting our final document transfer process and how it was implemented. The critical success factors are also delineated. Other health systems and collaborative groups of skilled nursing facilities may benefit from implementing similar processes.
To evaluate the effect of Hospital Admission Risk Program (HARP) on unplanned hospitalization, bed days, and mortality of enrolled individuals and to evaluate the cost-effectiveness of HARP.

A retrospective longitudinal analysis of hospital administrative data.

Individuals at risk of hospitalization were provided with multidisciplinary, community-based care support managed by care coordinators including integrated care planning, education, monitoring, service linkages, and general practitioner liaison over 6-9months.

Individuals who were enrolled into 1 of 8 HARP chronic disease management programs between July 1, 2017, and June 30, 2018, at the Royal Melbourne Hospital, Australia.

Hospital admissions between 18months before and 18months after HARP enrollment were analyzed. Total hospital costs were compared between 18months before and 12months after HARP enrollment.

A total of 1553 individuals with a median age of 71years (interquartile range 60-81), 63.4% males, were admitted to HARP. Both unplals between programs is preferable.
HARP reduced unplanned hospitalization and bed days but did not return individuals' hospital use to baseline before the intervention. The variations in mortality between HARP chronic disease management programs implies that condition-specific goals between programs is preferable.
The objective of this study was to evaluate the effects of single plane and multiplane rotational errors in yaw, pitch, and roll of the head while recording the lateral cephalogram on CVM (cervical vertebrae maturity) assessment.

A total of 40 cone-beam computed tomography (CBCT) scans and 360 lateral cephalograms were analyzed for patients with different rotations Controls (no rotation), Y5 (yaw 5° rotation), Y10 (yaw 10° rotation), R5 (roll 5° rotation), R10 (Roll 10° rotation), P5 (pitch 5° rotation), P10 (pitch 10° rotation), YRP5 (yaw, roll, and pitch 5° rotation), and YRP10 (yaw, roll, and pitch 10° rotation). The C2, C3, and C4 concavity and their base-anterior ratio and posterior-anterior ratio were measured. In addition, maxillomandibular linear parameters, such as effective mandibular length and height, mandibular body length, effective midface length, and maxillomandibular differential, were also evaluated.

Y5, Y10, R5, and R10 led to overestimation of CVM in comparison with controls. Multiplane rotations (YRP5 and YRP10) led to more inaccuracies in CVM measurements than single plane rotations; 10° of rotation led to more inaccuracies than 5° of rotation while recording the lateral cephalogram, irrespective of the plane. Yaw rotational errors led to an underestimation of maxillomandibular linear measurements, whereas roll rotational errors led to an overestimation of the measurements; however, there were wide individual variations in the measurements between the different rotations and controls.

Rotational errors lead to overestimation of CVM assessment. Multiplane rotations cause higher inaccuracies than single plane rotations. Increased degree of rotations while capturing the lateral cephalograms lead to more inaccuracies in CVM assessment.
Rotational errors lead to overestimation of CVM assessment. Multiplane rotations cause higher inaccuracies than single plane rotations. Increased degree of rotations while capturing the lateral cephalograms lead to more inaccuracies in CVM assessment.
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